The most effective exercises for vertigo depend on what’s causing it. For the most common type, called BPPV (where tiny crystals shift out of place in your inner ear), specific head repositioning maneuvers can resolve symptoms in one to three sessions. For ongoing dizziness caused by other vestibular conditions, a progressive series of eye, head, and balance exercises can retrain your brain to compensate. Here’s a breakdown of the main exercises, how to do them, and which type of vertigo each one targets.
The Epley Maneuver for BPPV
The Epley maneuver is the most widely used exercise for BPPV, which accounts for the majority of vertigo cases. It works by guiding the displaced crystals in your inner ear back to where they belong, using gravity and a specific sequence of head positions. Success rates range from 64% to 98% after one or more attempts, with most people seeing improvement after just one or two sessions.
Before you try this at home, you need to know which ear is affected. A clinician can determine this with a simple test: when your head is turned so one ear faces the floor and your eyes start flickering involuntarily, the crystals are in the ear closest to the ground. If you already know which ear is the problem, you can do the maneuver yourself.
Here’s how to perform it for the right ear (mirror everything for the left):
- Step 1: Sit on a bed. Turn your head 45 degrees to the right.
- Step 2: Quickly lie back, keeping your head turned. Your shoulders should land on the pillow with your head slightly reclined. Wait 30 seconds.
- Step 3: Turn your head 90 degrees to the left (without lifting it), so you’re now looking 45 degrees to the left. Wait 30 seconds.
- Step 4: Roll your head and body another 90 degrees to the left, into the bed. Wait 30 seconds.
- Step 5: Sit up on the left side.
You may feel a brief wave of dizziness during certain steps. That’s normal and usually means the crystals are moving. If the first attempt doesn’t fully resolve your symptoms, you can repeat it. In one clinical study, an experimental group reached a 100% success rate after just two attempts.
One common concern is whether you need to sleep upright or avoid certain positions afterward. Early guidelines recommended keeping your head upright for 48 hours. More recent evidence doesn’t support this. Multiple studies have concluded that post-maneuver restrictions are unnecessary and don’t improve outcomes.
Brandt-Daroff Exercises
Brandt-Daroff exercises are a gentler option, often recommended when the Epley maneuver hasn’t fully resolved BPPV or when you’re not sure which ear is affected. Rather than repositioning crystals in one precise sequence, these exercises work through repeated exposure to the triggering positions, helping your brain adapt.
To do them, sit on the edge of a bed. Quickly lie down on one side with your nose pointed about 45 degrees toward the ceiling. Stay there for 30 seconds, or longer if the dizziness hasn’t subsided. Then sit back up, wait 30 seconds, and repeat on the other side. That’s one repetition. Do several repetitions at least twice a day. Most people start to notice improvement within a week or two, though some need longer.
The BBQ Roll for Horizontal Canal BPPV
Not all BPPV affects the same part of the inner ear. When crystals lodge in the horizontal canal instead of the more common posterior canal, the Epley maneuver won’t work. The BBQ roll (also called the Lempert maneuver) targets this specific variant by rotating you 360 degrees through a series of positions.
For right-ear horizontal canal BPPV:
- Lie on your right side. Wait 30 seconds.
- Roll onto your back. Wait 30 seconds.
- Roll onto your left side. Wait 30 seconds.
- Tuck your chin slightly, roll onto your stomach, and prop yourself up on your elbows. Wait 30 seconds.
- Roll onto your right side. Wait 30 seconds.
- Slowly sit up, keeping your chin level.
This maneuver typically needs to be performed by or initially supervised by a clinician, since horizontal canal BPPV can be harder to diagnose at home.
Gaze Stability Exercises
If your vertigo stems from vestibular damage rather than loose crystals (from conditions like vestibular neuritis, labyrinthitis, or age-related inner ear decline), repositioning maneuvers won’t help. Instead, gaze stability exercises retrain the connection between your eyes and inner ear so your vision stays steady when you move your head.
The foundational version, called the X1 exercise, works like this: tape a small “X” on a blank wall at eye level. Stand or sit about an arm’s length away. Focus on the X and turn your head side to side as quickly as you can while keeping the X clear and in focus. Do the same thing vertically, tilting your head up and down. The goal is speed without blur. If the X gets blurry, slow down slightly.
The more advanced X2 version adds a moving target. Hold a card with an X on it at arm’s length. Move the card to the left while you turn your head to the right, then reverse. For the vertical version, move the card down while tilting your head up, and vice versa. The target must stay clear and focused throughout. This version doubles the challenge for your visual stabilization system and is typically introduced once you’ve mastered the X1 exercises.
Aim for one to two minutes per exercise, several times a day. These exercises will likely make you mildly dizzy at first. That’s expected and part of the retraining process. The dizziness during practice should decrease over days to weeks as your brain adapts.
Cawthorne-Cooksey Progressive Exercises
The Cawthorne-Cooksey series is a structured progression designed to gradually challenge your balance system from simple movements to complex, full-body activity. It’s commonly used in vestibular rehabilitation for chronic or recurring dizziness from various causes.
You start with basic movements while sitting on the edge of a bed. Bring your head as far back as you can, then forward to touch your chin to your chest. Turn your head side to side. Do these first with your eyes open, then with your eyes closed. Next, add shoulder shrugs and bending over to touch the ground with your fingers. Each exercise should be performed for about five minutes. When an exercise no longer triggers dizziness, move on to the next one in the sequence.
The later stages introduce standing exercises, walking in a straight line, and eventually activities like turning in circles or catching a ball. The entire program is designed so you do the exercises several times per day, progressing at your own pace. Some people move through the full sequence in a few weeks. Others with more significant vestibular damage may take months.
Safety Considerations
Most vertigo exercises are safe for people to try at home, but there are important exceptions. If you have a neck condition, back problems, or advanced rheumatoid arthritis, the head positioning required by maneuvers like the Epley can put strain on your cervical spine. Let your provider know about these conditions before attempting any repositioning maneuver.
For all exercises, do them near a bed or stable surface in case of a strong dizzy spell. Having someone with you the first time is a practical precaution, especially with the Epley and BBQ roll maneuvers where sudden dizziness is expected. If your vertigo is accompanied by new hearing loss, severe headaches, or difficulty speaking, those symptoms point to something other than a simple inner ear problem and need medical evaluation rather than home exercises.